Individual
CHARNIA HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4272 SAINT ANTOINE ST, DETROIT, MI 48201-2108
(313) 833-7309
Mailing address
19988 STOEPEL ST, DETROIT, MI 48221-1247
(601) 214-1461
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901022165
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2016
Last updated
03/17/2018
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